Specimen Information

Results of this assay distinguish positive (greater than or equal to 300 ng/mL) from negative samples only. The amount of drug detected in a positive sample cannot be estimated.

Methodology

Enzyme Immunoassay (EIA) [Moderate Complexity]

Clinical Significance

Used in diagnosis and treatment of opiate use or overdose Opiates are a class of compounds that includes morphine, codeine, and heroin. Morphine and codeine are naturally occurring alkaloids that are found in opium, a substance exuded from the unripe seedpod of the opium poppy Papaver somniferum. Heroin is a semisynthetic derivative of morphine. Morphine is a potent analgesic. Codeine is used in analgesic preparations and as a cough suppressant. Heroin is an even more potent analgesic than morphine. Both morphine and codeine are legitimate drugs. Heroin is a drug of abuse that may be snorted, smoked, or dissolved and injected subcutaneously or intravenously. Opiates are absorbed rapidly. Heroin is converted almost immediately to morphine, which is excreted in urine both unchanged and as a glucoronidated metabolite. Excretion takes place over a period of a couple of days. Codeine is excreted in urine as a glucoronidated conjugate, as free and conjugated norcodeine, and as morphine. The presence of opiates in the urine indicates the use of heroin, morphine and/or codeine. 6-Acetylmorphine (6-AM) is a metabolite of heroin; its presence is positive proof of heroin use. 6-AM has a very short half-life (i.e., it is detectable for only a few hours after heroin use). Current literature shows that 10 ng/mL is the lowest testing level by GC/MS that can reasonably be used to consistently and accurately identify and quantitate the presence of 6-AM.